Table 1. Clinical features, initial management and follow up of patients presenting with acute, non-traumatic adrenal haemorrhage.

No.	Age/gender	Clinical features and predisposing factors (other than abdominal pain)	Urgent intervention	Functionality	Follow up/status	Final diagnosis/pathology	Outcomes
1	77/M	Hypertension, on rivaroxaban	No	No	Repeat CT—reduced size with benign features; no surgery	Likely benign	Died of non-adrenal cause 28 months after presentation
2	89/F	INR 4.5, on warfarin	No	No	Repeat CT—increased size with features of malignancy; no surgery	Likely malignant	Died of non-adrenal cause 12 months after presentation
3	68/M	Hypertension, excessive sweating and feeling unwell, on rivaroxaban	No	No	Repeat MRI—reduced size with benign features; no surgery	Likely benign	Well at 26 months after presentation
4	44/F	Not reported	No	No	Repeat CT—‘normal’ adrenal; no surgery	Likely benign	Discharged well at 66 months after presentation
5	27/F	Shoulder tip pain, post-partum haemorrhage 6 weeks prior resulting in anemia	US guided drainage after resolution of bleeding	No	Repeat CT—infected collection; further percutaneous drainage and antibiotics done	Likely benign	Well at 6 months after presentation
6	64/F	Not reported	Left adrenal artery embolization	Pheochromocytoma	Repeat CT—persistent lesion; laparoscopic adrenalectomy done	Infarcted tumour—possible phaeochromocytoma	Well at 7 months after presentation
7	45/F	Not reported	US guided aspiration of collection after resolution of bleeding	No	Repeat CT—recurrent bleeding and progression; open adrenalectomy done for palliation of symptoms and bleeding	Adrenal metastasis (from breast cancer)	Died of metastatic breast cancer 5 months after presentation
8	72/M	Pain radiating to the back, sweating and clamminess, on warfarin	No	No	Subsequent admission for disseminated lung cancer; no surgery	Likely malignant	Died of metastatic lung cancer 2 months after presentation
9	27/F	Associated back pain	No	No	Repeat CT—persistent lesion; laparoscopic adrenalectomy done for persistent pain	Neurilemmoma with cystic degeneration	Well at 12 months after presentation
10	58/M	Not reported	No	No	Repeat MRI—reduced size, but persistent; hand-assist laparoscopic adrenalectomy to establish diagnosis	Cortical hyperplasia	Discharged well at 8 months after presentation
11	41/F	Nausea and vomiting	No	No	Repeat CT—persistent lesion, possibly malignant; open adrenalectomy and nephrectomy done	Oncocytic adrenal cortical neoplasm uncertain malignant potential	Well at 4 months after presentation